This in the future will effect the way we get reimbursed.
As new payment methods gain traction, the nation’s second-largest insurer is taking leaps and bounds to transition away from the traditional fee-for-service model toward value-based payments, reported Forbes.
Anthem wants to focus on enhancing payments for performance and shared-risk arrangements, CEO Joe Swedish said on a call with analysts and investors this week, noted the article.
Ultimately, Anthem intends to change how insurers and providers interact with one another in order to achieve the same end result: Lower medical costs.
“We have 118 accountable care arrangements as well as other collaborative efforts such as patient centered medical homes, hospital quality and safety programs, and other partnerships that share financial risk and gain,” Swedish said. Anthem has $38 billion invested in value-based contracts, representing 30 percent of its commercial claims.
The news comes after the Department of Health and Human Services announced that it would fundamentally reform how it pays providers for treating Medicare patients in the coming yearsby pushing for new payment models such as accountable care organizations and bundled payments. HHS hopes to cut down on the volume of unnecessary procedures while improving patient outcomes.
As of right now, just 20 percent of Medicare payments come from alternative payment programs. HHS wants to increase that to 50 percent by the end of 2018.
As indicated by Anthem, the payer community appears to be on board with HHS’s announcement.
“The commitment to improving the way physicians, hospitals and other providers are paid sends a strong and clear message, and it should result in long-term improvements in quality and affordability,” the Pacific Business Group on Health noted.
In addition to Anthem, UnitedHealth is working toward implementing value-based payments. At the end of 2014, the insurer announced a new bundled payment program that will pay MD Anderson Cancer Center in Houston a flat fee to provide head and neck cancer care.